FEATURE
hands-on work of sample accessioning , preanalytical data entry and result reporting can also create bottlenecks . In Oregon , a LIMS administrator added barcoding and automated parts of their reporting platform , slashing the time needed to create and check reports . The improvements have also decreased the human error that comes with manually handling hundreds or thousands of samples , said Laura Tsaknaridis , a microbiologist in the laboratory .
“ Now it ’ s so automated that it ’ s very difficult to get a specimen switched up or get the wrong accession number in there . That ’ s helped out a lot .”
… But Build in Redundancies
Despite the need to keep workflows as streamlined as possible , an element of strategic redundancy can help maintain operations throughout the volatile circumstances of a prolonged pandemic . Overwhelming demand and shifting manufacturer priorities have created ongoing supply challenges . And when gonorrhea and chlamydia tests , for example , use the same platforms as COVID-19 tests , completing a day ’ s work takes careful planning and allocation of available resources .
Diversification was a hard lesson learned from the pandemic , Southern said .
“ For our non-COVID-19 programs , sometimes we need to be able to pivot between different platforms ” to ensure that something is always up and running despite inconsistent supply chains . That represents significant investments in infrastructure , training and time , as scientists must establish proficiencies and competencies in redundant assays and complete additional validation and verification testing . But , he added , “ those kinds of strategic changes will allow us to [ handle ] surge in other areas beyond COVID-19 .”
Cross-training staff can also help finetune a laboratory ’ s effective capacity day-to-day . Wisconsin has shifted much of its COVID-19 testing to more automated instruments and trained their full serology team on those instruments , so they are able to step in if the virology staff are all unavailable . Similarly , virology staff can shift over and help with STI testing if needed . Such contingency planning has become even more pressing as Omicron sweeps the country , to manage both testing demands and the likelihood that some staff may be out sick or caring for family members .
Take Care of Your People , and They ’ ll Take Care of You
To keep things running , “ it comes down to having an amazing crew ,” Sevey said .
“ If people weren ’ t willing to come in and they weren ’ t passionate about what they did — I don ’ t know where we would be at this moment . We just have exceptional people working in public health .”
In the early stages of the pandemic , many laboratories adopted an all-hands-ondeck approach , with personnel stepping into new roles where possible to prioritize COVID-19 testing . But as other needs returned , staff have largely resumed their regular duties .
“ We were trying to hire new people ,” Bateman said . But “ government systems don ’ t move at the speed of a pandemic .”
Like most public health laboratories , Oregon implemented overtime and extended work weeks to get more done with the same number of employees — stopgap measures that have now stretched on for years .
“ We kind of scrambled , like everyone else in the country , to bridge these gaps . And they ’ re still there ,” Sevey said , echoing a common sentiment . Many temporary positions are now expiring , and filling specialized needs , such as informatics , can be especially hard .
Public Health Microbiologist II Kristina Davidovich performs Candida auris confirmation by MALDI-TOF on the Bruker Biotyper . Photo : Orange County Public Health Laboratory
Workforce issues are nothing new for Southern —“ we traditionally have a very difficult time recruiting staff to central South Dakota ”— and the pandemic ’ s challenges have refocused his attention on honing his existing team ’ s skills , coordination and morale . The efficiencies and collegiality born out of the COVID-19 response will boost the group moving forward , he said .
“ We ’ re focusing on resiliency , self-care , making sure that we all have a little bit of juice left in the tank to get us over that next whatever — the next week , the next month , the next testing campaign , the next surge ,” Southern said . “ I want to do the best I can to take care of that small team of mine , because there ’ s great power in what they can do . If I can keep culture and morale high in the laboratory , I know we ’ ll be able to navigate months [ or even ] another year of really difficult COVID and non-COVID programming .” •
8 LAB MATTERS Spring 2022